Blood Clotting Signals Stay Elevated in Women With Schizophrenia Despite Treatment Gains

Women with paranoid schizophrenia show heightened coagulation and fibrinolytic activity that persists even after their psychiatric symptoms improve with inpatient treatment, according to a study published in BMC Psychiatry. Researchers examined 50 women with paranoid schizophrenia, with a mean age of 31.9 years, before and after inpatient psychopharmacotherapy. To assess blood clotting dynamics, they used the Fibrinodynamics method, which measures several integrated parameters: overall coagulation potential (OCP), overall hemostasis potential (OHP), overall fibrinolysis potential (OFP), and OFP expressed as a percentage.

Reference intervals were established using samples from 45 healthy volunteers. Clinical status was evaluated with the Positive and Negative Syndrome Scale (PANSS) and the Hamilton Depression Rating Scale (HDRS), allowing the team to compare hemostatic measurements with the severity of psychotic and depressive symptoms at both time points. Before treatment, the patients displayed significantly increased OCP, OHP, and OFP compared with the reference values, indicating elevated activity in both the clot-forming and clot-dissolving arms of hemostasis.

Notably, OFP%, which reflects the relative balance between these opposing processes, remained within the reference interval at baseline. This pattern suggests that although clotting and fibrinolytic activity were both heightened, they were still relatively balanced against each other in individual patients. After the inpatient treatment period, PANSS and HDRS scores decreased significantly, confirming that the psychopharmacological intervention was clinically effective.

However, the Fibrinodynamics parameters themselves did not change significantly over the course of treatment. All hemostatic indices remained elevated relative to the healthy control group, showing no normalization despite measurable clinical improvement. One parameter did shift in a meaningful way: OFP% increased beyond the reference interval after treatment.

According to the authors, this suggests a greater inter-individual imbalance between procoagulant and profibrinolytic activity following therapy, meaning the previously balanced relationship between clot formation and clot breakdown may have become less stable across patients. The study also found that several Fibrinodynamics parameters correlated with PANSS and HDRS scores both before and after treatment. These statistical associations support the idea that hemostatic activity is linked to the clinical manifestations of schizophrenia, although correlation does not establish a causal direction between clotting physiology and psychiatric symptoms.

The research addresses a long-standing question in psychiatry: whether abnormalities in blood coagulation contribute to the pathophysiology of schizophrenia. However, the relationship between clotting profiles, clinical symptoms, and the effects of antipsychotic treatment has remained insufficiently understood. The authors conclude that women with paranoid schizophrenia in this cohort demonstrated elevated coagulation and fibrinolytic potentials alongside a potentially unstable hemostatic balance.

Importantly, inpatient psychopharmacotherapy, despite producing significant clinical improvement, was not associated with normalization of hemostatic parameters. As an observational study of a single cohort of female inpatients, the work cannot determine whether the hemostatic changes cause, result from, or merely accompany schizophrenia, and the findings apply specifically to women with paranoid schizophrenia receiving inpatient care. The authors note that the associations between Fibrinodynamics indices and psychopathological symptoms support a link between hemostasis and clinical manifestations of the disorder, providing a foundation for further research into how coagulation biology and schizophrenia intersect.

Subject of Research: Hemostasis profiling in women with paranoid schizophrenia before and after antipsychotic treatment

Article Title: Hemostasis profiling in women with paranoid schizophrenia before and after antipsychotic treatment using the Fibrinodynamics method

Article References: Karpova, N. S., Shilov, Y. E., Stolyarov, S. A., Oleichik, I. V., & Klyushnik, T. P. (2026). Hemostasis profiling in women with paranoid schizophrenia before and after antipsychotic treatment using the Fibrinodynamics method. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08816-1

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08816-1

Keywords: schizophrenia, hemostasis, coagulation, fibrinolysis, Fibrinodynamics, antipsychotic treatment, PANSS, BMC Psychiatry, women's health, psychiatry, cardiovascular risk, profiling